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AAP Grand Rounds 14:61-62 (2005) Renal Imaging Studies After First UTI in Infants: Cystography Has Limited UtilitySource: Moorthy I, Easly M, McHugh K, et al. The presence of vesicoureteric reflux does not identify a population at risk for renal scarring following a first urinary tract infection. Arch Dis Child. 2005;90:733736.
The objective of this retrospective study from 2 pediatric hospitals in England was to evaluate the utility of a cystourethrogram in infants younger than age 1 year at the time of a first urinary tract infection (UTI). Data were reviewed on 108 children with a bacteriologically proven first UTI and a normal urinary tract ultrasound at the time of the UTI. The children had cystography 6 weeks after the acute infection and a 99m-technetium DMSA scan to look for evidence of scarring and other renal damage 3 to 6 months later. Data on the 55 girls and 53 boys were analyzed on a "per renal unit" (kidney and ureter) rather than on a per patient basis.
Vesicoureteric reflux (VUR) was present in 25 renal units, 23 with grade 13 VUR and 2 with grade 45 VUR (from 1 male patient). A kidney was considered abnormal by DMSA scan if the differential function was
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